3/19/2015. Million Hearts : An Exemplary Platform for Teaching Interprofessional Practice & Population Health in Advanced Practice Nursing Curricula

Transcription

1 Million Hearts : An Exemplary Platform for Teaching Interprofessional Practice & Population Health in Advanced Practice Nursing Curricula Presenters Alice Teall MS, RN, FNP/PNP, FAANP Kate Gawlik, MS, RN, ANP, DNP(c) Margaret Clark Graham, PhD, RN, FNP/PNP, FAANP, FAAN Symposium Objectives NONPF 2015 Million Hearts Symposium 1.) The learner will be able to describe the Million Hearts initiative and key strategies for its advancement through interprofessional education and practice initiatives. 2.) The learner will be able to identify three ways to incorporate Million Hearts into advanced practice curricula and community outreach to improve population health. 1

2 NONPF 2015 Symposium 1 WHAT IS MILLION HEARTS? THE DISEASE BURDEN Heart Disease Burden Heart Disease is the leading cause of death for both men and women in the U.S. 1 Each year, about 735,000 people in the U.S. have a heart attack 2 Each year, about 610,000 people die of heart disease 1 1 in 4 deaths in the U.S. is due to heart disease 1 1. CDC, NCHS. Underlying Cause of Death on CDC WONDER Online Database, released Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed March 16, Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics 2015 update: a report from the American Heart Association. Circulation. 2015;131:e

3 Stroke Burden 1 in every 20 deaths in the U.S. is due to stroke 1 Every 4 minutes, someone dies of a stroke 2 Each year, about 795,000 people in the U.S. have a stroke Stroke is the third leading cause of death in the U.S CDC, NCHS. Underlying Cause of Death on CDC WONDER Online Database, released Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed March. 16, Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics 2015 update: a report from the American Heart Association. Circulation ;e WHAT IS THE MILLION HEARTS INITIATIVE? The Million Hearts Initiative The Million Hearts initiative focuses, coordinates, and enhances cardiovascular disease prevention activities across the public and private sectors in an unprecedented effort to prevent 1 million heart attacks and strokes by 2017 and demonstrates to the American people that improving the health system can save lives. - CDC,

4 Goals of Million Hearts Prevent 1 million heart attacks & strokes by 2017 Empower and educate Americans to make healthy choices Target care by focusing on the ABCSs Use proven clinical and communities strategies to prevent cardiovascular disease Centers for Disease Control and Prevention (n.d). Million Hearts. Retrieved from Reaching Goals Improving access to effective care Improving the quality of care for the ABCS Focusing clinical attention on the prevention of heart attack and stroke Activating the public to lead a heart-healthy lifestyle Improving the prescription and adherence to appropriate medications for the ABCS Centers for Disease Control and Prevention (n.d). The Initiative. Retrieved from PARTNERS 4

5 Key Partners Co-leaders of Million Hearts within the U.S. - Department of Health and Human Services - The Centers for Disease Control and Prevention - Centers for Medicare and Medicaid Services Key private-sector partners include American Heart Association American Nurses Association American Association of Colleges of Nursing American Association of Nurse Practitioners YMCA WHAT ARE THE ABCSs? Know your ABCSs Appropriate Aspirin Therapy Blood Pressure Control Cholesterol Management Smoking Cessation Stress Reduction** ** Ohio State s additional S Picture 5

6 Appropriate Aspirin Therapy The Million Hearts goal for 2017 is to increase aspirin use in high-risk candidates to 65% The U.S. Preventive Services Task Force 1 recommends aspirin therapy for cardiovascular disease and stroke prevention in: - Men years old - Women years old 1. US Preventive Services Task Force, Aspirin for Prevention of Cardiovascular Disease Blood Pressure Control The Million Hearts goal for 2017 is to achieve blood pressure control in 65% of people with hypertension Blood pressure guidelines 1 recommend initiating treatment for: BP of <140/90 for adults aged < 60 years BP of <150/90 for adults aged 60 years 1. The 8 th Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, Cholesterol Management The Million Hearts goal for 2017 is to achieve cholesterol control in 65% of people with high cholesterol Risk factors, disease states, LDL cholesterol levels, and an estimated 10 year risk of having an cardiovascular event determine whether cholesterol medication is initiated 1 factors Picture: ACC/AHA Guidelines on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adult 6

7 Smoking Cessation People who smoke increase their risk of heart disease by 2-4 times that of people who do not smoke 1 19% of the U.S. population smoke tobacco; The Million Hearts goal is to reduce this number to 17% 1. American Heart Association, 1997 Stress Reduction Stress can increase the body s release of certain hormones, such as cortisol and adrenaline Persistently elevated levels of these hormones from chronic stress may lead to serious health problems, such as heart disease and high blood pressure 1 1.National Institute of Mental Health, Fact Sheet on Stress The Million Hearts Initiative Controlling these risk factors can reduce risk of heart attack and stroke by more than 80% 1... Look at the that exists! 1. Centers for Disease Control and Prevention (n.d.) About Heart Disease and Stroke. Retrieved from 7

8 TAKING ACTION: REDUCING RISK Appropriate Aspirin Therapy Benefits and risks of aspirin therapy should be assessed with each patient If it is determined that aspirin is right for a patient, then determine which dose is indicated: - One baby aspirin (81 mg) daily, or - One aspirin (325 mg) every other day 1 1. Agency for Healthcare Research and Quality, Taking Aspirin to Prevent Strokes Blood Pressure Control If indicated, make sure the patient has been taking medication as directed Lifestyle Modifications for BP reduction include 1 : - Increased physical activity - Weight reduction - Adoption of the Dietary Approaches to Stop Hypertension (DASH) eating plan - Dietary sodium reduction - Moderation of alcohol consumption 1. The 7 th Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. 8

9 Cholesterol Management If indicated, make sure the patient has been taking medication as directed Lifestyle Modifications for cholesterol reduction include 1 : - Following a healthy diet high in fruits, vegetables, low-fat dairy foods, and whole grains and low in saturated fat, trans fat, and cholesterol - Weight reduction - Increased physical activity 1. Agency for Healthcare Research and Quality, High Cholesterol Smoking Cessation Advise quitting Proactive telephone counseling, group counseling, and individual counseling formats are effective and should be used Both counseling and medication should be provided to patients trying to quit smoking 1 1. Clinical Practice Guidelines: Treating Tobacco Use and Dependence, 2008 Stress Reduction No single method works for everyone or in every situation Some things to try: Eat a well balanced diet, listen to music, spend time with family or friends, deep breath, join a support group, keep a journal, practice yoga or meditation, exercise, take a walk or get a massage 9

10 TAKING THE PLEDGE The Million Hearts Pledge SIGN the Million Hearts pledge at millionhearts.hhs.gov COMMIT to changing just ONE thing PARTNER with us TODAY to provide the biggest Million Hearts outreach in the COUNTRY INTRODUCING. The National Interprofessional Education & Practice Consortium to Advance Million Hearts 10

11 What is NIEPCAMH? An association of academic institutions, community groups, and healthcare organizations who are committed to the advancement of Million Hearts and promoting population health through prevention and screening Our goal is to screen and educate 100,000 individuals by 2017 Picture: Join Us Today THANK YOU The Million Hearts word and logo marks, and the Be One in a Million Hearts slogan and logo marks and associated trade dress are owned by the U.S. Department of Health and Human Services (HHS). Use of these marks does not imply endorsement by HHS. Use of the marks also does not necessarily imply that the materials have been reviewed or approved by HHS. 11